Enough to make you sick: Holidays used to mean sun, surf and sand. Now its skin cancer, sewage and salmonella

A poisonous fish which can kill babies and frail pensioners with just one prick of its venomous spines is on the rampage off the south coast of England. The weever fish has struck holidaymakers in Bournemouth, Poole, and the Isle of Wight as they paddled innocently in the shallows, according to reports.

Lee Marshfield of the Sea Life Centre in Portsmouth is in no doubt about the risks these tiny fish pose to life and limb. 'They are rated as the most venomous creatures in Europe, in the same league as adders,' he warned earlier this week. 'If they sting a frail old person or a baby, it can easily mean death.'

Mass evacuation of beaches from Margate to Weymouth was surely the only option for resorts plagued by the fish, which escape the heat by burrowing into the cool sand, carelessly leaving a prickly fin exposed. In reality, the solution is somewhat less dramatic. 'Wear flip-flops or plastic sandals when paddling,' Mr Marshfield advised, adding that, if stung, hot water applied to the affected area would help ease the pain.

The 'Poison Jaws Threat to Holiday Beaches' - as some newspapers described this seasonal occurrence - is just the latest in a stream of health scares blighting the summer months.

A holiday once posed no greater threat than a few grains of sand in your sandwiches and some peeling skin. Not any more. Sun, surf, and sand have been usurped by skin cancer, sewage and salmonella. Then there is Legionnaire's Disease spraying forth from the shower in your holiday apartment; the Aids risk of a fling with a foreigner; disease-ridden hotel swimming pools; rabies, and malaria masquerading as flu - all this to think about before you even pick up a brochure.

Nor is a holiday at home any guarantee of safety. Last week the Cancer Research Campaign warned that Birmingham was as dangerous as Benidorm when it came to soaking up the rays in a heatwave.

And what about the influx of tainted foreign food: the Spanish iceberg lettuce that caused an outbreak of dysentery in May and June, the salmonella-infected tiramisu and worm-infested sushi dishes, all of which have been highlighted in recent weeks?

As we head into high summer, a well-earned break is foremost in the minds of most people and scare stories with a holiday angle can be made to fit all the requirements of the silly season.

Some scares are genuine but more often than not they are related to a single case or small local outbreak, and hyped as a wider threat. Warnings about worm-infested sushi, for example, related to a single case reported in a medical journal involving a Japanese woman in the UK who presumably ate a lot more raw fish than the rest of us. The dysentery 'outbreak' in the South and South-west - fewer than 200 cases above the seasonal norm, and causing a mild diarrhoea and sickness - was probably caused by one batch of lettuces washed in a river before export and not properly rinsed with tap water before eating. The tiramisu scare - 11 cases in a north London restaurant - posed the same well-publicised risks as any dish that uses raw eggs.

Common sense is probably the greatest asset for those stressed-out individuals about to depart for their two weeks in the sun, but here the Independent provides its own aide memoire to the essentials of a healthy holiday.

FOOD POISONING

Hot weather increases the risks of food poisoning because bacteria multiply faster in the heat. The highest number of outbreaks occur in summer months and are linked with restaurants and hotels which specialise in functions such as weddings. Mass catering and poor hygiene in hot weather intensify the risk, says Richard North, an independent environmental health officer. 'I think the bride and groom should, as a matter of course, opt for steak and chips or fish and chips at the wedding breakfast. My files are full of tragic stories of couples who spent their honeymoon between bed and bathroom.' He also advises against eating out in the last week of the school holidays, which is when food poisoning peaks - possibly related to last-minute days out and treats before term begins.

SKIN CANCER

Every year health educators kick off the summer with warnings about the damaging effect of sun on skin and the rise in skin cancers. Suncare manufacturers drive the message home with advertising and careful placing of editorial in magazines. The pounds 116m market is worth five times more than it was in 1982. The Meteorological Office has also got in on the act, and from 1 April this year began giving daily predictions on the risk of sunburn, from low through to very high.

Some experts believe that less strident warnings about the sun would have greater impact. We should understand that human beings love sunshine and warmth and a tan makes them feel and look better, says Dr John Hawk, a consultant dermatologist at the Guy's and St Thomas's Hospital Trust, London. 'Although one shouldn't go on holiday with the sole object of getting a tan, I am in favour of enjoying oneself in the sun, of indulging in whatever are your favourite activities.

'Avoid wanton exposure in the middle of the day if you can, and structure your day to avoid the hottest parts. But if you can't, make sure you are protected (suncream of factor 15 or higher) and keep applying it. If you come back with a tan having carefully adhered to the warnings and advice, then it is not going to be associated with an enormous amount of damage.'

DIRTY BEACHES

Britain has an unenviable record for polluted beaches and coastal waters, with holidaymakers at one in five of 457 bathing beaches immersing themselves last year in what was little more than diluted sewage, according to the Consumer's Association.

The health risks are real, as a study of sea bathing published earlier this year found. Swimmers in sewage-polluted waters were more likely to suffer diarrhoea and gastroenteritis - sewage-related illness - than people who stay on the beach. But swimming in unpolluted water was also related to an increased risk of eye irritations, skin rashes and throat infections - the human body is not intended for a marine environment.

Holidaymakers who shun dirty British beaches are not necessarily better off when in Europe. Mediterranean beaches have a better reputation but the EU suspects several countries of 'massaging' the figures. Greece, Italy, France, the Netherlands and Portugal allegedly fail to test all their beaches often enough to make their published results valid, and exclude results recorded during wet weather when sewers overflow into bathing waters. A recent EU report hinted that pollution in some Greek resorts was so low that samples were probably being left in the sunlight to breakdown before testing.

MALARIA

Keep taking the tablets. Many travellers forget or discount the need to continue with anti-malarial drugs for four weeks after they return from holiday. At least 2,000 people return to the UK each year with malaria and last year there were between eight and 10 deaths. Some deaths could have been avoided if doctors had recognised the symptoms earlier or been aware that the patients had been travelling in a malaria-infested region.

David Bradley, professor of tropical hygiene at the London School of Hygiene and Tropical Medicine, advises anyone who develops a fever or flu-like symptoms up to a year after their trip, to inform their doctor immediately of the possibility of malaria.

He urges GPs to consider it in any diagnosis. Self-help measures are important, too; cover exposed skin from dusk to dawn when mosquitos feed, use recommended mosquito repellant and a mosquito net if necessary.

Drug regimes vary depending on your destination - resistance is a growing problem - and should be started a week or two before you leave. Contact the Malaria Reference Laboratory's 24-hour Helpline on 0891 600350 (36p per minute cheap rate, 48p peak) for advice.